Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | 155628 | NY |
N | 2080P0207X | Pediatric Hematology-Oncologist | 155628 | NY |
NPI | 1154494185 |
---|---|
Provider Name | John W Moohr |
First Address | New York, NY 10003-6303 |
Second Address | New York, NY 10003-6303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 08/07/2007 |